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SGEM#432: SPEED, Give Me What I Need – To Diagnose Acute Aortic Dissections

The Skeptics' Guide to EM

Date: February 28, 2024 Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. Case: A 59-year-old man walks into your community emergency department (ED) complaining of chest pain.

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EM Journal Update: Prehospital Narrow Pulse Pressure Predicts Need for Resuscitative Thoracotomy and Emergent Intervention After Trauma

Core EM

A narrow pulse pressure has been shown to predict the need for hemorrhage control in the ED setting but has not been assessed as a predictor in the prehospital setting. A narrow pulse pressure occurs due to compensatory increased systemic vascular resistance in the setting of decreased cardiac output.

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Unstable Pelvic Trauma Patient: ED Presentations, Evaluation, and Management

EMDocs

C, respiratory rate 20 breaths per minute, and oxygen saturation 95% on room air. The nuances of fracture patterns and delineating mechanically unstable pelvic fractures from stable ones is less important to the ED. Her initial vital signs are blood pressure 76/54 mmHg, heart rate 128 bpm, temperature 37.0˚

ED 54
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Large bowel obstruction: ED presentation, evaluation, and management

EMDocs

7 While post-operative adhesive disease is also a risk factor, it is far less commonly implicated in LBO compared to SBO. 7 While post-operative adhesive disease is also a risk factor, it is far less commonly implicated in LBO compared to SBO. He reports distension and the sensation of fullness. Small bowel dilation may also be seen.

E-9-1-1 77
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First10EM Journal Club: May 2024

Broome Docs

Join Justin and I for a sold 80 minutes of nerdy evidence-based ED care. Video Laryngoscopy vs Direct Laryngoscopy for Endotracheal Intubation in the Operating Room: A Cluster Randomized Clinical Trial. Join Justin and I for a sold 80 minutes of nerdy evidence-based ED care. 2024 Mar 18:e240762. doi: 10.1001/jama.2024.0762.

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EM@3AM: Retroperitoneal Hematoma

EMDocs

A 70-year-old female with a past medical history of hypertension, coronary artery disease s/p 2x drug eluting stent placement one month ago, atrial fibrillation on apixaban presents to the ED with weakness and lightheadedness. F, RR 16, SpO2 97% on room air. Vital signs include BP 90/48, HR 122, T 98.3

EMS 74
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Cervical Spine Imaging in Kids – the PECARN rule

Don't Forget the Bubbles

Children in the validation cohort were admitted to the intensive care unit or operating room less frequently than those in the derivation cohort. A proportion of participants were missed because the ED provider refused enrollment or said “Other,” but this is not well described. What is the problem? What were the results?

CPR 124